title: The relationship between maternal serum prenatal screening combined with epidemiological study and early onset preeclampsia.
abstract: OBJECTIVE
  To explore the major risk factors and early prediction methods in the pathogenesis of early onset preeclampsia through combining prenatal screening markers and epidemiological characteristics.
  
  
  METHODS
  Prenatal screening was performed in second trimester using enzyme-linked immunosorbent assay in 1,011 gravidas and epidemiological correlation factors were got by telephone with prospective cohort study. Predictive model of early onset preeclampsia was established and evaluated by single and multiple factor logistic analysis in 30 cases of preeclampsia and 867 cases of normal gravidas.
  
  
  RESULTS
  As compared with the control group, the maternal serum level of human chorionic gonadotropin (hCG) in second trimester of patients with early onset preeclampsia elevated significantly (P < 0.001). Pregestational BMI ≥ 24 kg/m(2) (OR = 3.649, 95 % CI 1.600-8.321, P = 0.002), history of hypertension, diabetes and nephritis (OR = 55.724, 95 % CI 8.223-377.614, P < 0.001), family history of hypertension (OR = 6.777, 95 % CI 2.917-15.742, P < 0.001), and risk coefficient for trisomy 21 (OR = 3.688, 95 % CI 1.013-13.429, P = 0.048) were major risk factors of early onset preeclampsia. The sensitivity and specificity of predictive model were 70.0 and 75.1 %, when cutoff point was 0.249. The diagnostic accuracy of the logistic model was better than hCG.
  
  
  CONCLUSIONS
  In order to early prevent the onset and development of EOPE, it is necessary to strengthen pregestational and prenatal care for women in these aspects including pregestational BMI ≥ 24 kg/m(2), history of hypertension, diabetes, nephritis, family history of hypertension, and high risk for trisomy 21 syndrom.
authors.affiliation: Department of Obstetrics and Gynecology, Zhongda Hospital, Medical School, Southeast University, 87 Dingjiaqiao Road, Nanjing, 210009, Jiangsu Province, China, yuhong650325@sina.com.
authors.forename: Hong
authors.initials: H
authors.lastname: Yu
authors.forename: Yan-ting
authors.initials: YT
authors.lastname: Shen
authors.forename: Hai-ling
authors.initials: HL
authors.lastname: Li
authors.forename: Yun
authors.initials: Y
authors.lastname: Yan
authors.forename: Mu-lan
authors.initials: ML
authors.lastname: Ren
authors.forename: Bei
authors.initials: B
authors.lastname: Wang
mesh_terms: D000328:Adult; D015992:Body Mass Index; D016022:Case-Control Studies; D006063:Chorionic Gonadotropin / Q000097:blood; D025063:Chromosome Disorders / Q000453:epidemiology; D002882:Chromosomes, Human, Pair 13; D003920:Diabetes Mellitus / Q000453:epidemiology; D004314:Down Syndrome / Q000453:epidemiology; D042241:Early Diagnosis; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D016015:Logistic Models; D009393:Nephritis / Q000453:epidemiology; D011225:Pre-Eclampsia / Q000097:blood* / Q000175:diagnosis*; D011247:Pregnancy / Q000097:blood*; D011262:Pregnancy Trimester, Second; D011296:Prenatal Diagnosis; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014314:Trisomy; D000073839:Trisomy 13 Syndrome; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D006063:Chorionic Gonadotropin; D000509:alpha-Fetoproteins